Miscarriages and pregnancy losses at different stages of pregnancy, complexed medical puzzles, are on the increase. Most of the Ob/Gyn doctors have no time and no experience to treat patients who lose every pregnancy they conceive. “Miscarriage work up” testing with hysterosalpingogram, x- ray of the uterine cavity and tubes, ‘thick blood’ coagulation factors and both parents. karyotype seldom brings definite answer to etiology (reason) for the losses. No explanation and no clear directions is given to patient what should she do in the future. When a routine evaluation ‘miscarriage workup’ turns negative problem remains unsolved with encouraging advise ‘try again since everything is fine with you.
Genetic Causes
Genetics are most often investigated, but genetic problems are found in only 3% of patients who suffer frequent miscarriages. Carriers of genetic diseases are served best with IVF with embryo biopsy and genetics testing utilizing Pre-implantation Genetic Diagnosis (PGD) to select disease free embryo for the implantation in the uterus
Women, Who Lost Two, Three or More Pregnancies
Patients with recurrent losses have rightfully difficulties to accept grim prognosis that nothing could be done to protect her tiny baby from destruction early on in the womb. Patient becomes withdrawn depressed and surely convinced that she will never become a mother. Recent advances in understanding maternal Immune System role in early pregnancy gave much needed in- site into demystifying nature of the many unexplained miscarriages. Abnormal maternal immune responses may cause recurrent implantation failure producing chemical pregnancies and failed multiple IVF attempts
New Therapies
New Therapies emerged giving good chances to reverse ‘bad luck’ needed to for successful pregnancy. In early miscarriages it is absolutely essential to implement therapy as early as possible, virtually at the START of pregnancy. IVF and embryo transfer gives unique opportunity to synchronize time of starting medications that will protect early pregnancy and neutralize destructive, aberrant reactions at the time when embryo is small and defenseless. Unfortunately, hardly ever any patient is referred with recommendations to be treated with IVF and/or undergo advanced investigation; both needed to improve outcomes
Gestational Carrier for Pregnancy Losses
Women who were born without uterus or had surgery need gestational carrier (other women) to carry and deliver her baby. Many recurrent miscarriages patients feel that use of somebody else’s uterus is going to solve problem of their body ‘killing’’ pregnancy. Finding a suitable gestational carrier, hire lawyer to prepare legal contract before treatment, is a difficult task. When there is no a family members or friend to become a carrier and help, patients look for a stranger to ‘hire’. There are professional agencies contracting ‘third-party reproduction’ (name used for gestational carrier services). Not many families, however, can afford surrogacy service fees that average between $80-100, 000 charged by those agencies. The good news is that majority of our pregnancy loss patients successfully carried pregnancy in their own wombs
